Cow's milk for babies, therapy for trauma, and lives saved by COVID vaccines
Tegan Taylor: Hello and welcome to the Health Report with me, Tegan Taylor, on Gadigal land.
Norman Swan: And me, Norman Swan, on Wurundjeri land.
Today we're going to cover a controversy that's emerged over the last few days about whether you can give six-month-olds or six-month- to 12-month-olds cow milk instead of formula. That's what the WHO has seemingly recommended.
Tegan Taylor: That isn't what we recommend in Australia, is it?
Norman Swan: It's not. No cow's milk until you are a year old.
Tegan Taylor: And last year we reported that the Bone Marrow Donor Registry had decided to use its own money to fund drives for new donors. Now the government has released about $4 million in funding, which is great. But the question, as it always is with stories like this, is will it be enough?
Norman Swan: But, Tegan, let's just talk about the news of the week. And I just want to point people to our special bonus podcast that we did at the beginning of the week, I think it dropped on Tuesday, on schizophrenia. It was in the public conversation related to the Bondi Junction tragedy over the weekend, and we'd thought we'd explain what schizophrenia is, and you can find that wherever you get your podcasts. And we've also got coming up on the show today…a lot of people have been traumatised by this who are near and far, and there is therapy available and we're going to be talking about that.
Tegan Taylor: We do have quite a few news stories to talk about today that I'm very excited to dig into with you. But before I do, Norman, you and me received an email from a listener this week. It was about a term that you told me about, it's a Scottish term called peely-wally.
Norman Swan: So we say, 'You're looking peely-wally, hen,' which means you're looking a bit pale.
Tegan Taylor: Yeah, so I'd said, hilariously, that it was Gaelic, because I just assumed it was. Anyway, it's not. Keith has written in saying that it's got a Hindustani origin. He spent a lot of his psychiatry career working in India and Pakistan. And early on in Keith's time in India he was sitting in New Delhi Airport chatting with a Scottish teacher who was telling him about the Hindustani language's influence on Scottish phrases, and they actually use peely-wally as an example. Do you want to know the etymology of…?
Norman Swan: Yeah, I'm fascinated, go on.
Tegan Taylor: So 'peely' is a form of the adjective 'yellow', and 'wally' is the suffix that turns the adjective into a noun. So 'peely-wally' means 'the yellow one'. This person also told Keith that Glasgow mums, if they wanted their children to hurry up, would say 'put a jaldi on it', which is another loan word from Hindustani that means 'fast'. Norman, please explain how Scottish…
Norman Swan: Well, I've got another one, 'doolally'. And my grandmother used to use it, 'She's looking a bit doolally.' 'Doolally' kind of means, well, she's a bit vague and a bit out of it is really the kind of description that most people would have used 'doolally'. And it turns out that it comes from an Indian town called Deolali, where British troops would be in a transit camp before they came back to Britain or on their way to India, and they got so bored there they went doolally. And that's where the term came from.
Tegan Taylor: I love this Indian–Scottish connection. You learn about so much more than just health stuff on the Health Report.
Norman Swan: We are expanding the vocabulary of Australia, apart from Scottish Australians.
Tegan Taylor: So of course, you and me, Norman, have had quite a few chats over the last four years about COVID-19. We did a whole podcast about it. And there was some really big research that came out this past week about how effective Covid vaccines were in preventing deaths in New South Wales. And they did some fancy modelling and they said in New South Wales alone, COVID-19 vaccines probably prevented nearly 18,000 deaths.
Norman Swan: Yeah, and that was very conservative. So this was a group of Melbourne researchers, and it must have killed them because they're actually taking New South Wales data because it was better than Victorian data (ha-ha-ha). And complicated research, sophisticated research, so we're looking at lots of different things, but the conclusion they came to was that vaccination saved thousands of lives just in New South Wales. So that's not a national figure, that's just in New South Wales. So in fact their original figure, when they looked at the deaths that were saved by vaccination, they got a bit over 21,000 in fact, but then they overlayed with some very conservative calculations and got down to about 17,760 deaths. But what they also showed was that in real life, unvaccinated people were hugely at extra risk, and they were looking at the over-50s. So just briefly, if you were unvaccinated you had a risk of death of 19.8 per 100,000. If you just had one dose of the vaccine, that plummeted to 4.7 per 100,000. Two doses of vaccine, 2.6, so it halved. And then if you had a booster dose, 1.8. So compared to the boosted population, unvaccinated people had 11.2 times the risk of dying if you're over 50. So, extraordinary.
Tegan Taylor: I think this is really interesting because when we were talking about this at the time with Coronacast, we were talking about the slow rate of the vaccine rollout and some disappointment, I think, around the fact that the vaccines didn't provide complete protection against any sort of infection. But when you're looking at this data, it really shows that it made a big, big difference.
Norman Swan: It did, indeed.
And there's also been some interesting research on autism spectrum disorder.
Tegan Taylor: Yeah, this is looking at the fact that there's such a big difference between the sexes.
Norman Swan: Yes, somebody will argue with how much the difference is, but boys are diagnosed more than girls. And the question is, why? Is it environmental, is it genetic? A big study in Sweden looked at this and they've come to the conclusion that they couldn't find an environmental reason for why boys were diagnosed…and this is a big study of the Swedish population…the conclusion they came to is that there's a genetic reason, so there's different genes operating in boys versus girls, which almost doubles the rate of autism spectrum disorder, but it's still 1.5% in boys compared to 0.8% in girls.
And I just thought I might run through some of what we know and don't know about the risk factors for autism spectrum disorders. We know that high blood pressure and pregnancy, smoking and pregnancy, premature rupture of membranes, prolonged labour, caesarean section, IVF, none of those increase the risk. Vaccination does not increase the risk, despite there being a scare a few years ago, there's been a lot of research on that. There's a little bit of doubt about risk in pesticide exposure, autoimmune disease, season of birth and air pollution, probably not.
And what is associated with increased risk, an older brother or sister with autism spectrum disorder, a shortage of oxygen at birth, which may be the baby itself, some babies developmentally are more at risk of shortage of oxygen at birth, and that may go along with autism spectrum disorder, so that's a bit confusing. Parental age does matter, and the mother more than the father. And so around the age of 40, a mother has a 75% increased risk of a baby with autism spectrum disorder, and a man in his late 50s, a father, a 40% increase.
Now, just before we leave this topic, I just want to put this into perspective. If it's round about a 1% chance of having autism spectrum disorder, and you've got a 75% increased risk, it goes up to 1.75% risk of having a baby…
Tegan Taylor: So, a very low base.
Norman Swan: That's right. So it's still a 98.25% chance of not having a baby with autism spectrum disorder. So you've just got to be careful about that. Another risk is a drug called valproate for epilepsy and mothers who've got epilepsy. And there are others which may be a risk, which is a short interval between pregnancies, preterm birth, maternal obesity, and gestational diabetes. And what's protective is a good folic acid intake.
Tegan Taylor: It feels like one of those ones I want to dig into a lot deeper, I think we might need to come back to that. But Norman, I want to tell you a story…actually no, I want you to listen to this first.
Speaker: My name is Karl and in my 76 I feel myself like a 25-years-old man. That's because I clean my vessels with this natural remedy. Believe you or not, I guarantee what you'll feel much better from first spoon. Link below and check my new interview.
Tegan Taylor: Do you know who that is?
Norman Swan: That's our old friend Karl.
Tegan Taylor: Well, it kind of is. It's not Dr Karl, it's a fake video. I don't know if you could tell from the way he was speaking.
Norman Swan: So it's a fake Kruszelnicki.
Tegan Taylor: That's it. So these videos of Dr Karl have been popping up all over social media websites over the last little while selling scam health pills. And our colleague in the ABC science unit James Purtill has been looking into it this week, because it seems to be one of those spaces where the tech companies haven't been able to keep up with this sort of boom in AI, and it has a real kind of health effect on people.
Norman Swan: Yeah, people don't know whether to believe it. It's happened to me a couple of times, where …I can't remember, I think I was flogging at one point something for erectile dysfunction, and another alternative medicine for blood pressure. And people were writing emails to me at my ABC email address saying 'Is this real? Tell me whether it's real or not, I can't believe that you're doing this'. And I actually got the ABC's legal office to try and stop it and they failed. There hasn't been one for a while. I don't know whether to be upset about that or happy but, no, seriously, it's pretty unpleasant when it happens. And it's confusing the audience.
Tegan Taylor: This is it. So yeah, it's not nice if it happens to you, but even though they seem pretty fake, the actual scam as a whole is quite sophisticated. So in this case with Dr Karl, it's an ad that's purporting to sell a blood pressure pill, but then there were also fake news stories, ostensibly written by Karl Stefanovic, and also fake Chemist Warehouse websites that were all AI generated articles that supported this. So then if you see the thing with Dr Karl and you Google it, the first few results on Google are these scam articles. So it kind of creates this hall of mirrors effect where you're like, well, I did my research, I checked my stuff and it's fine. And people are falling into this trap and buying stuff.
Norman Swan: It's poisonous. I think it happened to Andrew Forrest recommending some investment strategy. So it's around, and so buyer beware. Don't believe a word that Karl Kruszelnicki or Norman Swan says.
Tegan Taylor: No, I don't want you to say that because that's part of the problem is that I think that what happens is you're telling people to be savvy, so they stop believing what could be a credible news source. And I think that the regulators are not quite keeping up. So the ABC, James Purtill asked the Therapeutic Goods Administration about it, and they said that they couldn't comment on individual cases. It is definitely a breach of the Australian Consumer Law, according to the legal experts that he spoke to. The ACCC referred him back to the TGA again. And I think the thing with these is they look so fake now but the AI is only going to get better. AI is a health issue.
Norman Swan: It is. And as I said, the ABC with its resources failed to get the social media companies to take this down, in my case anyway.
Tegan Taylor: Well, if you want to read James's story about this, which I definitely recommend you do because he does a much better job of telling the story than I do, you can find that on the ABC News website. We'll put a link in our show notes as well.
Norman Swan: And it's real.
Tegan Taylor: You're with the Health Report.
Norman Swan: I want to get back to the story about trauma, Tegan, as a result of the attack in the Assyrian church, and a few days earlier the terrible attack in the Bondi Junction Mall. Lots of people were traumatised, not just people who were in the mall, people who live nearby, but I think it also had an impact on the national psyche. And in some people, that trauma would have been on top of previous trauma and really disrupting people's lives. Now, there is help available for people who find that trauma is affecting their lives and affecting them psychologically. It's called cognitive behavioural therapy with a trauma focus. They've done a review of the evidence of this and it does work, and the person who led the review was Anke de Haan, who's a postdoctoral research fellow at Ruhr University in Bochum in Germany. But the research she did was conducted at the University of Cambridge.
Anke de Haan: There is no typical story really. They experienced either an accidental trauma, for example a road traffic accident or natural disaster, or an interpersonal trauma, for example sexual assault, physical violence or war. And they experienced this trauma either once or several times, and some of them might also have experienced different types of trauma, once or several times. So their stories are all very different.
Norman Swan: But not everybody who experiences trauma ends up with a mental health issue.
Anke de Haan: Yeah, that's a really important point. It's true, not everyone who experienced a trauma has a mental health issue, and some have mental health issues in the beginning, but then their symptoms subside in the first days and weeks after the event. We call this natural recovery. But then some experience ongoing trauma related symptoms, and these symptoms can be very different, even for two people that were exposed to the same traumatic experience, are the same age, come from a similar background, et cetera, and the symptoms can be related to post traumatic stress disorder, depression, anxiety, obsessive compulsive disorder, conduct disorder, substance abuse disorder, anything really.
And often young people meet criteria for more than one disorder. For example, they meet criteria for post traumatic stress disorder and depression. And we sometimes see a combination of internalising and externalising problems. So some show aggressive behaviour and low mood. And in addition to that, traumatic experiences can often have negative impacts on their relationships with family, friends, school or work. But then again, the areas of life impacted by the trauma can be very different from young person to young person.
Norman Swan: Given the picture is so complex, it makes the decision about what treatment is right for that person incredibly complicated too.
Anke de Haan: We do have good evidence for CBT with a trauma focus for a variety of disorders. So actually we're at kind of a good place to treat this complex picture.
Norman Swan: So what happens in CBT with a trauma focus, cognitive behavioural therapy with a trauma focus, compared to, say, standard cognitive behavioural therapy for, say, depression, which is probably the commonest use for it?
Anke de Haan: In general, both have a similar structure and apply the same techniques, but CBT with a trauma focus links the treatment components to the traumatic experience. And what is unique is the part where a trauma narrative is created, and the trauma narrative includes the whole traumatic experience described in detail, either in written or verbal form or as art. So some young people create a comic, for example. And the trauma narrative helps to organise the trauma memories, because sometimes the memories of what happened are very disorganised and it needs work to put everything together. And the trauma narrative is also a way to confront oneself with the trauma and learn step by step that one is strong enough to deal with it. One final really important point about the trauma narrative is that it often uncovers dysfunctional beliefs about the trauma itself or its consequences, which then can be evaluated and challenged with the help of the therapist. And sometimes creating this trauma narrative is not enough, but it's also really important to confront situations, places and people that the patient had avoided since a traumatic event.
Norman Swan: Can you give me an example of where you might have misplaced beliefs?
Anke de Haan: For example, children, sometimes they blame themselves for the traumatic event, but it wasn't their fault at all. So, for example, they were in the car with their parents, and then an accident happened and then they said, oh, it was my fault because I was too loud or because I was asking a question. But it was not their fault at all. And there are other things…with sexual abuse, for example, we often see the case that children and also young people blame themselves and say, like, I wore the wrong dress, or my dress was too short, and then they blame themselves. So it's really important to challenge those beliefs and make sure that they have a clear picture of what happened.
Norman Swan: In some senses, when I hear this description of trauma therapy, it's a bit like desensitisation when you've got a phobia. In other words, there's something in your life that you're really scared of and the therapy kind of makes you confront it, like fear of spiders or fear of flying, that sort of thing. I'm not trying to trivialise trauma, but by confronting it, it helps you deal with it.
Anke de Haan: Totally true, it's kind of like that. The exposure to the traumatic event, to the trauma story, and reading it over and over again, discussing it over and over again, helps to deal with it.
Norman Swan: So you brought together the available evidence for the benefits of this in terms of the research that's been done globally. What did you find?
Anke de Haan: We found CBT with the trauma focus is superior to active and passive control conditions for treating post traumatic stress symptoms, and also depression and anxiety.
Norman Swan: When you say control situations, what's that? What's it compared to?
Anke de Haan: We had a variety of comparisons. So some studies just compared it to a waitlist condition. That means the young person waited for maybe three months before they received treatment. That's like the weakest control condition you can have. But then we had other trials that compared CBT with a trauma focus against meditation, for example, or counselling, and treatment as usual.
Norman Swan: And what do benefits actually mean? What were the outcomes?
Anke de Haan: The young person that received CBT with a trauma focus had lower PTSD symptoms, for example, after treatment.
Norman Swan: So in other words, their distress as a result of the trauma was lower, or their depression was relieved, to some extent.
Anke de Haan: Yes.
Norman Swan: How long did the benefits last? Because for some forms of cognitive behavioural therapy you need top-ups.
Anke de Haan: Yeah, so that's actually a really good question. So for our study, we can conclude for a year, the benefits lasted for a year. We didn't look further. Long-term follow-up is very scarce.
Norman Swan: One of the issues with cognitive behavioural therapy is that the randomised trials show that it works really well but as long as the therapist, the psychologist, sticks to the protocol, in other words, follows the rules. But in the real world, they've found that psychologists…in fact, it's paradoxical; the longer the psychologist has been in practice, the more they depart from the protocol for CBT, and therefore in theory the less effective they are. Did you look at adherence to protocol?
Anke de Haan: No, we didn't. I think it's always a balance, right? So you have the protocol, and you know that it's working, but then you have the client in front of you, and then every client, every patient is different, so of course you have to adapt your treatment with this patient. So it's always a balance to sticking to the protocol but of course treating the patient the way he needs.
Norman Swan: Trauma in various forms is actually quite common. It's not a one-to-one relationship, as we said right at the beginning, between trauma and a mental health issue. If somebody is listening who's experienced trauma and is struggling psychologically, what are the sorts of questions they should ask their general practitioner about who they should be referred to?
Anke de Haan: So I think it's really good to reach out to your GP, I think that's the first or the second thing you might want to do. So first, talk to someone you trust, your parents, your teacher, but then I think the GP is the right place to go because he can arrange mental health support and can make a mental health plan and so on. So I think that's the person to go to, and then talk about what you've explained, and how you're feeling and what your difficulties are in life, and then the GP has a good picture to arrange mental health support.
Norman Swan: So the GP will have a choice of psychologists that he or she could refer to, but they need to be looking for somebody who is a psychologist who has been trained in CBT with a trauma focus.
Anke de Haan: Yes, to take the best treatment possible, yes.
Norman Swan: So is there a place that people can go for more information?
Anke de Haan: Yeah, so at Phoenixaustralia.org, which has a lot of useful resources.
Norman Swan: Anke, thank you very much for joining us.
Anke de Haan: Thank you so much for having me.
Norman Swan: That's Dr Anke de Haan, a postdoctoral research fellow in clinical child and adolescent psychology at Ruhr University in Bochum, Germany.
Tegan Taylor: So, Norman, you were mentioning before some controversy around a mismatch between the World Health Organisation's guidelines and the Australian guidelines about what milks are appropriate to give to babies, especially babies as young as six months. And it kind of follows on from some of the reporting you've been doing in the last few weeks for us around toddler foods and toddler milks.
Norman Swan: Yeah, so the World Health Organisation puts out infant feeding and child feeding guidelines, and they change them every so often, and they've changed the infant feeding guidelines over the last few days to cover babies between six months and a year old or six and 11 months, who are not breastfed, and they've said for the first time that they can have cow's milk. And authorities and experts in Australia have been…I suppose they've been outraged by it because it doesn't comply with Australian infant feeding guidelines. And it highlights some of the disparities that can occur between the World Health Organisation that's trying to get a global view and global advice going, versus countries like Australia, which are very different from low-income countries.
And another reason, Tegan, I'm interested in this is that…and I cover this in the interview so I won't go into any great detail…is that paediatricians in Australia and allergists in Australia bend over backwards to comply with World Health Organisation feeding guidelines, sometimes to the detriment of kids who run the risk of developing food allergies. But have a listen to this interview that I did earlier with Rachel Laws, who's Associate Professor of Public Health Nutrition at Deakin University.
Rachel Laws: The latest WHO recommendations are that non-breastfed infants between six and 11 months can be fed either formula or animal milk, and that's different to what the Australian infant feeding guidelines recommend, that in infants less than 12 months that cow's milk isn't given as the main drink.
Norman Swan: Now, they weren't terribly confident about this. What's led to it?
Rachel Laws: WHO guidelines obviously cover a range of countries. And these guidelines are really in place for countries where there is limited access to animal foods, there may be unsafe water, unsafe sanitation or indeed access to infant formula, and in those countries, animal milks may indeed be a preferred option. But clearly this isn't the case in Australia.
Norman Swan: Rachel, what was the evidence that they based this decision on?
Rachel Laws: WHO undertook a systematic review, which is an evidence synthesis of trying to pull together results from a number of studies, and they included nine studies. A few of these studies were conducted more than 20 years ago and all were of low quality, which means that we can just be less confident in the results of those studies.
Norman Swan: So what's the problem with cow's milk from six months?
Rachel Laws: The main problem with cow's milk from six months of age is the evidence that cow's milk at between six and 11 months of age has been associated with an increased risk of iron deficiency anaemia. When infants are around six months of age, their needs for iron increase. And there's quite reasonable evidence that cow's milk can increase the risk of iron deficiency anaemia in children under 12 months of age. And there's also concerns about the protein level in cow's milk, which is double the protein content of both breast milk and formula. And we know that high intakes of protein in early infancy are associated with an increased risk of obesity.
Norman Swan: So at its core, this is all about a period of a child's life when they're dependent on milk.
Rachel Laws: Correct. And ideally breastfeeding is the preferred form of milk and fluids at that age. But in the case where parents aren't breastfeeding, then the Australian infant feeding guidelines do continue to recommend formula milk as the other alternative.
Norman Swan: There's something else I wanted to ask you about the WHO guidelines because when you look at the evidence, introducing solids early prevents food allergies, not 100% but reduces the risk of food allergy. And yet you've got paediatricians and paediatric allergists really being a bit nervous about saying that at four or five months you should introduce solids, they really go with six months. And when you ask them why (because that condemns some children to food allergies, waiting to six months), they say, well, we don't want to contradict the WHO guidelines because WHO guidelines say no solids until after six months. Are the WHO guidelines just becoming a bit irrelevant for countries like Australia?
Rachel Laws: Well, the Australian infant feeding guidelines also recommend introducing solids around six months.
Norman Swan: But what I understand is they're following WHO guidelines and WHO guidelines are no longer in tune with the evidence.
Rachel Laws: I think there's a range of evidence. The allergy field is one area, but the other area is child obesity. And we do know that there's some evidence that early introduction of solids before four months of age is associated with an increased risk of obesity. And I think the guidelines around allergies are introducing solids around six months of age, but not before four months of age. So I think that's the critical message here.
Norman Swan: But still questions whether WHO can ever fulfil the need to be global when they're dealing with so many different countries at different levels of nutritional availability.
Rachel Laws: I think that's a very fair point, Norman. And they do say in their guidelines that this is a conditional recommendation. And that means that the recommendations do vary by context, and that each country needs to consider the balance of the benefits versus the harms. And our National Health and Medical Research Council have actually just released a statement on their website in the last day or so that does reinforce sticking with the current infant feeding guidelines of not feeding cow's milk or animal milks to infants under 12 months of age as the main drinks.
Norman Swan: Rachel, thank you very much for joining us.
Rachel Laws: Thanks very much.
Norman Swan: So I think what that means is it's business as usual, Tegan, that the advice for Australian mothers and fathers of infants is, if they're being formula fed, keep them formula fed until they are 12 months old and then start introducing cow's milk, along with water, because they're getting most of their nutrition from solids.
Tegan Taylor: You're listening to the Health Report.
Bone marrow transplants or stem cell transplants are high risk but also lifesaving procedures, and this is something that we've covered a little bit on the Health Report over the last year or so, which we're coming back to because there's been some movement here. These sorts of procedures are often taken on cancer patients, either because their bone marrow has been destroyed by the treatment or because it's the bone marrow that's been invaded by cancer cells. And sometimes that person's own stem cells can be used. Other times they need a donor. And for that they need to find a match, the best match that they can. But the problem here in Australia is that our donor pool is tiny. We often rely on donors from overseas to save lives locally. And, as I said last year, we reported that the Bone Marrow Donor Registry had decided to use its own money to fund drives for new donors while it waited on government funding. Now the government has released $4.2 million for the cause. But producer Shelby Traynor has been speaking to people who say that's not nearly enough.
Tahlee Bearham: Well, in 2019, in November, my brother was diagnosed with AML leukaemia. He'd just come back from his honeymoon; he'd been married two weeks.
Shelby Traynor: Not long after Tahlee's brother Matt was diagnosed, his team started looking for a stem cell match in case he would need a transplant down the line.
Tahlee Bearham: They sent me in for testing straightaway, and I just kept thinking, gosh, there's a lot riding on this test, please let me be a match, please let me be a match. Full siblings only have a one-quarter chance of being a match for their sibling who needs a donation. The test results came back and my brother was the one to tell me that I was only a 50% match, and they were really needing a 100% match. I was really upset and he said, 'Don't worry, there's an Australian registry. We're going to look there and try and find a match there.'
Shelby Traynor: As we've reported before on the Health Report, Australia's donor pool is small and lacks diversity. No one on the registry at the time was a good enough match for Matt.
Tahlee Bearham: It doesn't mean that there wasn't a match. There might have been a match down the street in another suburb in another state, but they weren't registered on the registry so they couldn't be found and they couldn't be asked to help.
Shelby Traynor: Tahlee says this is by no means the public's fault, because so few people are aware of stem cell donation and what it entails.
Tahlee Bearham: I wish more people knew about it. I wish the government would fund more recruitment drives for it.
Shelby Traynor: The federal government released $4.2 million last month to the donor registry and the Red Cross. This money comes from the Cord Blood Export Revenue Fund. This is a fund accumulating cash every time Australian cord blood is sent overseas. Lisa Smith is the CEO of the Australian Bone Marrow Donor Registry, and she says while the funds are welcome, it's not enough.
Lisa Smith: There is still in excess of about $10 million sitting there in those funds. So this is a small one-off commitment. It really doesn't change the longer-term picture.
Shelby Traynor: So if there's $10 million sitting in a fund somewhere, why can't it be used?
Lisa Smith: Well, that's the $10 million question. It's certainly not through a lack of appreciation of the issues. A couple of years ago, governments put out a national framework where they identified and articulated all of the reasons why donor recruitment in Australia needed to increase significantly.
Shelby Traynor: At the moment, we're heavily reliant on overseas donors, and by extension, overseas travel.
Lisa Smith: Only last month with the German airports and the strikes that affected them, we had five patients in Australia and we were trying to get cells out of Germany and into Australia during that period. There are risks to patients from this overwhelming dependence on donors that are so far away, and governments acknowledge that. They also acknowledge the ethical issues of Australia as a first world country expecting donors from elsewhere to step up for our patients, where we do not contribute donors to the global donor pool. They've identified the cost implications for importing cells from those countries, as well as because we have such a small donor pool and we don't contribute cells to overseas patients, we don't get that income in return which governments can use to offset their investments. So governments have clearly articulated all of the reasons why there is this need for additional investment. A big part of the challenge that we face is really establishing a baseline level of education and awareness across the community, but it's not something that can be quickly achieved. That requires an ongoing sustained investment into public education and awareness campaigns.
Shelby Traynor: So if the government understands the importance of a robust donor pool, why aren't the funds being released? Unfortunately, Lisa Smith doesn't have the answer.
Lisa Smith: It's just completely baffling. I would understand if I was bidding, you know, against all the other health sector for budget funds. You know, I know the budget is upcoming and money is tied, and so we would be completely understanding if that was the issue, but the fact that the money is literally sitting in our bank account, and it's not as though there are other uses that have been identified for this money, and it has been sitting there for 24 years, that is the truly perplexing…and even the model itself, you know, the fact that a charity is holding this money for this long, really on behalf of governments, is in itself baffling.
Shelby Traynor: Tahlee Bearham lost her brother Matt in 2021. While Matt did eventually find a donor from Germany and did receive a transplant, he'd deteriorated considerably during the wait. Three years on from his death, Tahlee is honouring his memory at Parliament House.
Tahlee Bearham: On the 24th of April it will be the three-year anniversary of my brother's passing away from leukaemia. It's also actually one day after my birthday. So what I'm doing is I'm asking for birthday gifts…is that okay to ask for birthday gifts from complete strangers?
Shelby Traynor: She's asking people, especially those between 18 and 35, to register as a stem cell donor and share the word on social media.
Tahlee Bearham: Aussies are really, really generous people, everyone wants to help each other, and I feel like people would want to help each other if they knew about it. They don't know it's so easy that you can just go online at Strength To Give, they'll send you out a free cheek swab kit, you just take a swab of inside your mouth, send it back to them free of charge, and you're on the registry. You'll be able to save somebody's life if they call you up. And it's not a scary process, 90% of the time it's just like giving blood, it just takes a little bit longer. It means the world to me just to be able to talk about this and educate people because people just don't know about it, and it's not their fault that we need to make a change and we need to do it urgently.
Tegan Taylor: Shelby Traynor there following up on a previous story on bone marrow transplants, which is really worth going back and having a listen to. We'll have a link to that piece on our website.
Norman Swan: Well, that's it for the Health Report for this week. If you just happened across this podcast, what you need to do is go back and subscribe so you don't miss a single episode.
Tegan Taylor: And if you want more of us (and why wouldn't you) you can listen to What's That Rash?. This week we are talking about whether it's possible to boost your immune system; supplements, certain foods, is there anything that works?
Norman Swan: Yes, there is but you're going to have to listen to find out.
Tegan Taylor: So you can find What's That Rash? on the ABC Listen app. And while you're there, make sure you hit subscribe, and why not go back and listen to a few, I feel like we've talked about some good stuff over the last few weeks, Norman.
Norman Swan: We have indeed. Otherwise, we'll see you next week.
Tegan Taylor: See you then.
New research is looking at the influence of gender on autism spectrum disorder diagnoses.
Calculating how many lives were saved by Australia's Covid-19 vaccine roll-out; and why it's important to be able to spot a fake Dr Karl, or Dr Swan, in the wilds of social media marketing.
A review into how cognitive behavioural therapy can help young people who've experienced trauma.
Recently updated WHO guidelines say babies as young as six months can start drinking cow's milk rather than infant formula, but that contradicts Australia's national guidelines.
And the Federal Government has recently released more funds to build the local bone marrow donor system… but is it enough?
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